Provider Demographics
NPI:1457911679
Name:VELA, VICTORIA LEIGH
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LEIGH
Last Name:VELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4349 35TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1504
Mailing Address - Country:US
Mailing Address - Phone:951-295-8107
Mailing Address - Fax:
Practice Address - Street 1:321 VAN HOUTEN AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5128
Practice Address - Country:US
Practice Address - Phone:619-383-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst